Hesperian Health Guides

Working for change

In this chapter:

A woman's disability affects not just herself. It affects many people: her family, friends, and most of all, her community. A woman with a disability can become more healthy when those around value and support her. Changing the way women with disabilities are treated is hard work. But it is not impossible.

a woman using sign language.
I dream of a day when people from around the world finally understand that having a disability is not the same as being sick; and that we are usually very healthy. And like all women, we need to stay healthy.


What women with disabilities can do

Make your voices heard by advocating for your rights and making sure disability issues become a priority.

  • Refuse to be confined to one place. Be adventurous and welcome different experiences.
  • Learn business skills, and empower yourself economically.

Finding security in the market

Oppah Ndlovu from Zimbabwe is a wheelchair user and is a respected member of her community. She started a successful project selling vegetables and tomatoes. Now, community groups purchase vegetables from her. With this steady income, Oppah has managed to buy a house.

a woman in a wheelchair speaking.
Share your stories.
  • Insist on participating at all levels in the community.
  • Become role models for other girls and women.
  • Speak about your disabilities.
  • Offer to accompany other disabled girls and women
    to where they need to go.
  • Take part in sports.



Olympic-level athletes

a woman in a racing wheelchair.

An increasing number of women are taking part in the Paralympic Games, an international sporting competition for athletes with disabilities including mobility disabilities, amputations, visual disabilities, and cerebral palsy. The Paralympic Games are held every 4 years, following the Olympic Games. It is an eye-opener for many people to see women with disabilities compete with confidence and skill.


Bowler dispels myths

Constance Sibanda, a blind bowler, was nominated the Sportsperson of the Year in Uganda, dispelling myths that as a woman with a disability she was "long dead and useless." Constance won a double gold medal in a world competition. Since then she has amassed more medals in blind bowling and participated in competitions in South Africa, Scotland, and the United Kingdom. Constance challenges all women and girls to explore their hidden talents.

Together you can decide what things in your community can be changed in order to make life better for all. For example, you can:

an instructor teaching a group of women to read.
Repeat after me... education.
EDUCATION!
  • start a literacy class for the women who cannot read or write.
  • start a small business together, making and selling crafts or tools.
  • share information with each other about community services and work together to make them more accessible.
  • try to get funds-- either through a low-interest loan or through a donation--to begin an income-earning project or to make the community more accessible.
  • raise awareness about disabilities and advocate for new ways of thinking about independence.
  • work with local leaders or the government to get better treatment for women with disabilities.

You can also help community groups:

  • Look at the different causes of health problems that you and other women with disabilities face, and decide which ones the community can change.
  • Take action by advocating for activities and services that make life better for everyone, including better health care, education, and transport for people with disabilities. Insist on accessible facilities.
a woman using sign language.
At one time, deaf people in Uganda were not allowed to drive. But because we protested, we can now buy cars and are allowed to drive.
  • Set up a small group. The voice of an organization is stronger than the voice of an individual. Make a plan about what the group will do and what steps the group will take to carry out each of these ideas.
  • Raise your voice against policies and laws that discriminate against you.

Educating people to get access

Dorothy, a wheelchair user in Bangalore, a state capital in India, found that the building which housed the chief minister's offices had no ramps. Also, the entrance to the building was too narrow for her to enter. She spoke about this to the guards and insisted they help her keep her appointment.

Afterwards, Dorothy sent hundreds of emails to tell people what had happened. This increased the pressure on the government to make changes.

At another time, Dorothy attended a cricket match, where the police asked her, "Why do you want to come here and watch the cricket match live? You might as well sit at home and watch the match on TV comfortably." She replied that, just like others, she too wanted to see the match live.

What families can do

The way women with disabilities are treated by their families, friends, and other people who assist them makes a big difference. Many times a girl with a disability is seen as stupid, dependent, unable to help herself and others, and therefore does not deserve any resources. Sometimes families also see her as a shameful burden to be hidden away, and they deny her the right to be heard or to make her own decisions. If this happens in a family or community, the problem is not with a girl or woman with disability, but with the people around her.

4 women with disabilities speaking.
Even though women work longer hours than men, we are always seen as liabilities. No one will give time, expenses, or effort to meet the needs of girls with disabilities.
No one ever lets me hold a baby. Because I have a disability, they think the baby won't be safe.
When someone comes, first thing my family does is to ask me to go inside. Even my sister is ashamed to introduce me to her friends.
My family has too much expectation of me. They are not satisfied unless I do very well in my studies. They say, "God has given Mai something special to compensate for taking away a good thing from her."

Nurture confidence

When Christine was 13 years old, her leg was amputated because of an illness. At first, Christine thought it was the end of her dreams. But her parents treated her well and soon Christine's confidence was restored. At first Christine's parents overprotected her, but she insisted they treat her like her other siblings. Christine was able to finish her college and received awards for excellence. The change in Christine made the rest of her family and community realize that Christine's missing leg would not keep her from fulfilling her dreams.

The only thing that can change these attitudes is social awareness. Women and girls with disabilities need good food, education, health care, and opportunities to be involved in physical and social activities. See Chapter 3: Mental health and Chapter 15: Support for caregivers.

three women with disabilities speaking.
We must be able to make decisions about things that concern us and our families.
They said, "If you go into social work, your clients will see you and get scared." But my mother supported and guided me. She told me I could do it. And today I feel proud that I have achieved what I set out to do.
Respect, accept, and love and value me. Remember, I have a mind and can do things for myself. If you do everything for me, you will make me disabled.

You can develop many skills

Hong Ha from Laos had polio when she was 2 years old. With the support of her family, she was able to graduate from university with a degree in French. When Hong Ha could not find a job, she learned to sew and then opened a sewing shop at home. Together with sewing, she started to study English. With a friend, Hong Ha then opened a small English training center at her home. She is also a coordinator of a program on disability.

Early assistance

In their first years of life, all children will learn more physical, mental, communication, and social skills and learn them more quickly and easily than at any other time in their lives. Since a baby starts learning as soon as she is born, it is important that families begin giving extra attention to help children with disabilities as soon as possible.

This is important because each new skill a child learns builds on the skills she already has. Each new skill also makes it possible for her to learn other, more difficult skills. So when a child does not learn a skill, she cannot learn other skills that depend on it.

Start a support group for parents of disabled children

Women with disabled children are often deserted by their partners and have to bring up their children by themselves. Parent support groups can help. Adult women with disabilities can offer advice on the types of concerns that girls with disabilities will face as they are growing. This can help their mothers support them better.

You can also start a support group for teenage girls with disabilities so they can help and support each other.

What communities can do

a woman with a visual disability speaking.
When health workers, teachers, community leaders, our families, and neighbors change their attitude to disability, we can do our work, have strong relationships, and make our communities rich and strong.

Community groups can help government, health workers, teachers, community-based rehabilitation workers, and community leaders learn about disability issues. They can also make the public aware through street plays, discussions, and in other ways that women with disabilities have the same rights to education, health care and transportation as non-disabled people. Communities can create employment opportunities and give information about services for women with disabilities.

Girls and women with disabilities become confident, believe in themselves, and grow to their full potential when parents and families love and accept them, and when they can get education, jobs, and health care. All community resources, such as schools, banks, religious places, hospitals, and clinics must also become accessible for everyone.

a girl with crutches sitting outside a classroom where a boy with crutches sits at a desk.
Disabled girls have fewer opportunities to go to school than disabled boys.

Education

Education is very important for girls with disabilities, including education in sign language and Braille or audio cassettes, for girls who are deaf, or blind.

In many poor countries, if disabled girls are not able to go to school and get an education, they may end up begging to survive when they are adults.

a woman sitting in a wheelchair at a computer.
Knowing how to read and write makes it possible
for me to earn a living with dignity.

It can make a big difference when a whole community works for educational rights for people with disabilities.

Community-based groups can discuss problems and encourage everyone, including other children, to welcome and respect girls with disabilities. They can arrange opportunities for early childhood education, or access government grants, or help in other ways. With education, girls with disabilities can support and enrich their communities.

Make communities accessible for everyone

All around the world, women with disabilities are organizing to help make clinics, schools, markets, city streets, buses, and communities more accessible for people with disabilities.

a woman speaking as she sits in a wheelchair in the doorway of a house; steps lead to the ground.
I feel helpless. I always have to rely on other people to help me leave the house. If there was a ramp down from our house and ramps to enter public buildings, I could get around on my own. I could go out when I want, and I would not always have to wait for other people.

Communities can make sure buildings and roads are accessible when they are first built rather than changing them later. This way all public facilities are as usable as possible by as many people as possible regardless of age, ability, or situation. They will serve people who are young or old, with excellent or limited abilities, in ideal or difficult circumstances. See “Low-cost ideas to make health center and hospital buildings easier to use.”

But access is about more than physical things such as ramps. Accessibility also means everyone can communicate and understand what is happening. Then a woman with a disability can do more things for herself and more people will see that disability is a natural part of life. When disabled women are valuable members of the community, the community will start thinking differently about disability.

Governments must provide the resources necessary to make transportation systems, buildings, public programs and facilities easy to use for everyone, including women with disabilities. Some governments penalize those who refuse to cooperate.

a woman speaking.
Here are examples of how women with disabilities have made changes in their communities.

Getting the government to make changes

people with disabilities using ramps at a post office and train station.

After taking part in a workshop on barrier-free access, the Lao Disabled Women's Development Center produced a videotape about barrier-free access for people with disabilities. They started talking to the different government sectors about facilitating participation of people with disabilities in society. Their ideas were approved by the Prime Minister's office, the ministries of communication, transportation, post and construction, labor and social welfare, and foreign affairs. They were able to get funds to construct ramps at 47 places in the capital city, Vientiane.


Making access possible

As a child, Alicia Contreras of Mexico became disabled from polio. A wise therapist counseled Alicia's parents on the importance of motivating her to be independent. Her parents arranged for her to attend regular school from childcare through high school. Alicia was the first student with a disability in her school, and her success there opened the schoolhouse doors to more children with disabilities.

Eventually, Alicia went on to university. She had a class on the third floor, and it wasn’t easy to climb the stairs using crutches. Alicia went to the university director and asked him to move the class from the third floor to the first. He agreed right away. “They had another room available,” Alicia recalled. “But the director had never thought about how students with disabilities would not be able to get to classrooms on upper floors, and I never thought to ask.” Other times, Alicia had to fight harder to make changes.

Alicia became a member of a disability association called “Free Access.” The group believed people with disabilities had the same rights as everybody else and worked to make the community more accessible. For example, they discussed with city transportation officials how difficult it was for people with disabilities to move around the city.
Alicia meeting with the university director.
As a result, the city adapted some buses to make them accessible to people with physical disabilities.


Free Access is still active today. Since 1993, it has worked with government officials and non-governmental organizations to promote changes to better the lives of people with disabilities. And there is still so much more to be done!

Changing policies is not easy. It can be long and complicated. It can take many years and a lot of effort by many people. You must understand the costs, the people affected, and the politics that affect the conditions you want to change. It is easy to feel discouraged if you are organizing for change. When you feel overwhelmed or discouraged, try to seek advice from other women with disabilities elsewhere in your country, and even outside your country. And remember you have a right to use all public facilities. You can create an accessible community.

Here is a story about people with disabilities who formed a group that made great change in their city.

Making a city accessible

In Ekaterinburg, Russia, the Freedom of Movement Society has been working together with the city government to make their city more accessible. Russian law requires that people with disabilities should be able to use public buildings and buses, but many places are still not accessible. The city government in Ekaterinburg developed a disability program to make buildings accessible.

But a group of people with disabilities who use wheelchairs or crutches realized that, even though the government had been trying to help, many of the places they had changed were still hard for disabled people to use. They realized the government could not do it without the help of people with disabilities.

people with disabilities telling city officials of the need for Braille signs, ramps, and low sidewalks.


So the people with disabilities formed the Freedom of Movement Society. They started by making a list of the most important places in the city to make accessible. They met with city officials, and showed them the list. The city realized they needed the advice of people with disabilities. The Freedom of Movement Society made sure their members were included in the city committee that became responsible for improving access. The people with disabilities had to approve any project the committee decided to do.

The Freedom of Movement Society created guidelines that architects could use to make buildings accessible. They were able to take photographs of buildings they wanted to fix, and then draw clear pictures of how to make changes.

Now, the old buildings are slowly being changed. And the new guidelines are used all over the city. Because of the work of the Freedom of Movement Society, all new office buildings and many other buildings are accessible to people with disabilities. New sidewalks are lowered in places for people who use wheelchairs. The new city mall is easy for people with disabilities to use. The Freedom of Movement Society also got the city to make several schools as well as the city's movie theater accessible.

Disability World

Taking action

a woman with a crutch speaking.
Here are some other ideas for women with disabilities to help their communities take action.
  • Organize social activities that help disabled girls come out of their homes and meet other people with disabilities and other young girls
  • Share information about finding or creating work.
  • Support women who are treated badly at home or in public or in the workplace.
  • Offer training in leadership and social skills.

Providing resources for change in Uganda


a disabled woman selling fruits and vegetables to 2 other women.

The Uganda Disabled Women's Association maintains a revolving loan program for disabled women to start their own businesses, provides education and mobility aids, and runs a drama group to raise public awareness about disabled women. They strive to increase disabled women's rights and well-being, to advocate for better education for disabled children, to teach independent living skills, to share reproductive health information, and "to fight poverty, ignorance, social differences, and disease."


Women make change happen in El Salvador

a group of disabled women having a discussion.

In El Salvador, the disability rights group ACOGIPRI has organized women's programs since 1987, bringing together disabled women from diverse backgrounds to hold discussions about sexuality and other issues. They also:

  • provide literacy and leadership training.
  • make aids and services available to girls and women with any form of disability.
  • prevent discrimination and violence.



Communities are stronger when everyone is included

3 women with disabilities speaking.
We are pressing for greater inclusion in the community...
...and working for change in health and education.
I dream of a day when all women with disabilities can be independent, have families, and use public facilities the same as everyone else!
Despite barriers of prejudice, ignorance and discrimination, women with disabilities around the world are improving their skills for self-sufficiency.

Women with disabilities must be heard when decisions are made at every level and about every issue--not just disability issues. No one has all the answers. Everyone, women and men, both with and without disabilities, people who struggle for human rights, and for the rights of workers and for the dignity of women in all parts of the world must join together to support women with disabilities to live healthy, independent, and productive lives. By making sure we nurture life in each of us, and learn from each other, we can build a more just world for all of us.

a blind woman speaking.
Let's discuss what changes in our community will help everyone become more involved and help all people have better health.


This page was updated:30 Nov 2023